The present invention relates to the field of managing a brain stroke (also called cerebrovascular insult or brain attack). In particular, the present invention is directed to a medical method for deciding how to manage the therapy of a stroke.
A stroke is a disease in which a patient's brain is not sufficiently supplied with blood at least at certain locations in the brain. The affected brain regions may therefore suffer from hypoxemia which will lead to cell death in the respective brain regions and loss of their corresponding neurologic function.
In general, two different kinds of stroke have to be considered. The first kind of stroke is called ischemic stroke and is caused a blockage of a blood vessel supplying blood, oxygen and nutrients to the brain. The blockage thus in general is an arterial embolism in an artery leading to the brain. The other kind of stroke is called hemorrhagic stroke and is defined as a hemorrhage from a blood vessel into the brain. A hemorrhagic stroke may be caused by a ruptured aneurysm in the brain or other medical indications involving the rupture of a blood vessel in the brain (for example arteriovenous malformation or in the case of blunt or open head trauma where exertion of an external force exerted onto the brain may lead to such a rupture). Due to a continuing flow of blood into the brain and a closed volume available for accommodating the brain (the volume being defined by the patient's skull), a hemorrhage into brain tissue will cause the brain pressure (intracranial pressure—ICP) to rise. An increase of intracranial pressure, however, in general leads to destruction of brain cells and corresponding loss of brain function.
Since different approaches are applied for therapy of these two kinds of stroke, and since a potentially time-dependent loss of brain function should be avoided, it is of great importance to quickly diagnose which kind of stroke a patient is suffering from. A quick diagnosis will allow reducing the time until a vessel blockage is removed in order to allow the respective brain region to be supplied with blood again, or until the patient can undergo craniotomy in order to reduce the intracranial pressure.
A present approach to diagnosis includes generating a magnetic resonance angiography or computed tomography angiography of the patient's brain. From the resulting image, a physician can then judge what kind of stroke the patient is suffering from.
Once the kind of stroke has been diagnosed, the patient can undergo further therapy. Presently, the patient has to be placed onto a bed which is fixedly attached to a magnetic resonance tomograph or computer x-ray tomograph for generating the angiography. However, in order to conduct the therapy, the patient will have to be removed from the tomograph and be taken to an operating room or other units of a health care institution. The resulting time required for removing the patient from the tomograph, placing him on a mobile bed and transporting him to the operating room or other unit necessarily delays therapy.
Therefore it is an object of the present invention to provide a method of managing a stroke which avoids or at least reduces a time delay between diagnosis and therapy.
The present invention is designed for use with angiography planning software supplied by Brainlab®.